A 62 year-old man is found on a routine physical examination to have an enlarged spleen. He is mildly anemic and has a white blood cell count of 29,000 cells/mm3. Review of his medical record shows that his white blood cell count 2 years previously at a community hospital had been 25,000 cells/mm³, and that this abnormal finding had not been followed up. A peripheral blood smear shows a large number of fairly mature-appearing cells that are slightly larger than red blood cells and have a single, round nucleus with scant cytoplasm. What is the most likely diagnosis?

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The Answer is D

A 62 Year-Old Man Is Found on a Routine Physical